Vacuum instrument for dental hygiene and dental treatment

ABSTRACT

A vacuum instrument for dental hygiene and dental treatment which is intended to permit parodontological treatment of the tooth pockets. The instrument has an elastic suction cap which can produce a sealed vacuum over the gum pockets and interdental crevices. A treatment liquid is supplied to the suction cap and removed by the suction. Intermittent application of the vacuum produces a pumping action, which through likewise intermittent rinsing results in optimal cleaning of the interdental crevices as far as the base of the pocket.

The invention relates to a vacuum instrument for dental treatment, T.

A vacuum instrument for the treatment of the root canals of teeth isknown from CH A 294 164. It serves for the treatment of tooth cavitiesfor the purpose of rinsing and drying thereof. In this case, a suctioncap with a conical wall is used in such a way that by appropriateexpansion, as a cap, it encloses the crown of the tooth to be treated.In this state, by means of the reversible valve, instead of the vacuumpump, the supply of treatment solution is connected to the vacuum spaceproduced, which then flows into the tooth as the vacuum disappears andcan be removed again by subsequent evacuation. For the removal of theentire device, the valve is completely closed, whereupon the cap can beremoved from the tooth.

For disinfectant treatment of the tooth, according to FR A 2 588 469, aU shaped body consisting of porous material, approximately adapted tothe shape of a tooth, at the end of a toothbrush-like handle is known,which can be supplied from the grip of the handle with a treatment agentin such a way that on its inside it transfers this agent to the teeth.The treatment agent is placed under slight excess pressure for acting onthe teeth.

In comparison therewith, the present invention provides a vacuuminstrument, which is intended to permit parodontological treatment ofthe tooth pockets. Normally the crevice between the tooth pocket walland tooth wall is not accessible for treatment, because this gap isclosed by the capillary adhesion and is unreachable. These forces aregreater the narrower the crevice. In this case, the gum with theinterdental papillae lies directly on the surface of the tooth and inthe region of the neck of the tooth and of the interdental gaps forms avery slender crevice, the so-called gum pockets, which may be of greateror lesser depth and which are under the action of the capillary forces.Despite the capillary adhesion, foreign bodies enter these free spaces,which can no longer be removed, so that in the bottom of the gum pocket,they are frequently subject to bacterial decomposition.

Due to the patent claims proposed in order to achieve the object set,the aforementioned capillary adhesion forces are overcome and the opencrevices are made accessible to medication in a particularly effectivemanner.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side elevation of the vacuum instrument.

FIG. 2 is a graph of the vacuum and rinsing sequence.

The present invention is based on the fact that by means of the suctioncap, a sealed vacuum can be produced over the gum pockets andinterdental crevices. This is the prerequisite for the beginning of theaction. As regards the type of action of the vacuum instrument, itshould be mentioned in advance that in very narrow crevices, in whichthe lateral surfaces lie directly one against the other, molecularforces and attraction forces between wall and liquid molecules exist,which cause the phenomenon of "capillary adhesion", known by the termcapillary tube effect. This manifests itself in that in a very narrowtube=capillary tube immersed in water, the water rises, so that theliquid level within the capillary tube is higher than outside. Thissucking-in of the liquid is caused by the capillary attraction forces,which also draw liquids into crevices and retain them there intensively.The narrower the crevice, the greater the capillary action, thus it isinversely proportional to the narrowness of the cavity. These capillaryforces are cancelled out by vacuum and the contents of the crevice aresucked outwards, i.e. into the vacuum. Solely under these conditions dothe crevices set free and empty themselves of the contents (liquid andsuspended particles located therein) previously retained by thecapillary forces.

Similar conditions exist in the dental region. In this case, the gumwith the interdental papillae rests directly on the surface of the toothand in the region of the neck of the tooth and the interdental gapsforms an extremely slender crevice, the so-called gum pockets, which mayhave a greater or lesser depth and in which the capillary forces arelikewise active. Due to the capillary adhesion forces, particles of foodproduced by chewing together with liquid inevitably pass into thesecrevices, which then no longer release the latter. Consequently, thefood particles generally remain at the bottom of the gum pockets and atthis point are frequently subject to fermentation and bacterialdecomposition. The single possibility of reaching, i.e. opening up thedepth of these capillary crevices is achieved, as mentioned above, byovercoming the capillary adhesion forces with the aid of a vacuum.Toothbrushes and oral rinsing are of no use here, in the absence of avacuum.

One particular effect of the vacuum instrument is achieved by using anintermittent vacuum. When the vacuum is shut off, the capillary forcesin the crevices again come into effect and draw in the rinsing liquid.On the other hand, due to renewed neutralisation of the capillaryforces, renewed switching-on of the vacuum empties the crevice. Thereverse effect is thus achieved, i.e. a pumping action is set up, whichnot only guarantees the actual rinsing-out of the gum pockets, but alsofacilitates the introduction of drugs to the very base of the pockets.Due to the inclusion of the intermittent vacuum, i.e. of the pumpingaction, a repeated exchange of the contents of the tooth pockets andthus maximum emptying of the crevice with regard to impurities(fermentable foreign substances, conglomerations of bacteria inter alia)is achieved. The principle is simple, the effect optimum, especially dueto the fact that parodontic processes can not solely be prevented butthe cause of them can be tackled.

With previously existing dental rinsing apparatus (German PatentSpecifications Nos. 125 410, 181 904, 517 203, 572 741 and 729 861) theeffect of removing the contents from gum pockets is not achieved, sincein the latter the sealed vacuum over interdental crevices is missing.With these methods, as a result of the presistence of the capillaryforces, the rinsing liquid cannot even penetrate the gum pockets, sincethe latter are not emptied. The purpose of rinsing is thus completelymissed. The rinsing liquid sqirted on remains outside the crevices andis sucked off again solely from the surface of the gum by the suctioncannula, without having fulfilled the function of deep cleaning.

According to the invention, the vacuum instrument achieves the objectintended for it by the solution features described in the characterisingpart of Patent Claim 1.

The mounting apparatus for the rinsing liquid or drug ampoule on thehandpiece also proved appropriate. The contents of the ampoules passesby way of a valvetype connection to the liquid tube and the cannula inthe working region of the suction cap. The route by way of a liquid tubefrom the treatment unit would be too long and would make relativelysimple monitoring of the admission of liquid impossible, quite apartfrom the lack of economy, since above all, when introducing drugs, apart thereof is left behind and would be lost.

The vacuum instrument for dental treatment acquires a particular aspectif one considers the opening-up of gum pockets from the point of view ofeffective cleaning thereof as regards foreign substances causinginflammation, since these very crevices are frequently to be regarded asthe starting point of inflammation and feared dental caries.Considerable savings could be made on artificial dentures if such aninstrument could be made commercially available.

The functional parts of the vacuum instrument for dental treatment areshown in the drawing. The replaceable funnel-shaped elastic suction cap1 is seated on the suction pipe 3. The likewise replaceable rinsingcannula 2 is located within the suction cap. The two covers 4 and 6 canbe attached to the handpiece 5, the suction tube 8 as well as therinsing liquid tube 7 being attached to the cover 6. Located at thelower end of the rinsing liquid tube are the mounting parts 10, 11 and12 for the rinsing liquid or drug ampoules 13. Located in the uppermounting 10 is an air-supply valve, in order that the rinsing liquid orthe drug may pass due to the suction force of the existing vacuum intothe liquid tube and the cannula in the working region of the suctioncap. The lower mounting 12 is able to slide according to the size of theampoule to be inserted. The liquid tube immersed in the ampoule isexchangeable (14) in the form of a cannula according to the size of theampoule and the quantity of liquid (rinsing liquid or drug) to beintroduced. Located in the region of the vacuum pump (not shown) is ashut-off as well as a rotary restriction valve, which regulates thevacuum value at between 100-150 mm Hg and on the other hand permits theintermittent vacuum for a sliding time interval of 1-5 seconds. Theoperation takes place by way of the handpiece.

The intermittent vacuum has particular functions on account of thepumping action caused thereby, in the region of the gum pockets. Theaddition of rinsing liquid takes place by introducing the rinsing liquidampoule in the vacuum phase, since then the contents of the pockets arelocated outside, i.e. in the region of the pocket opening as a result ofcancellation of the capillary forces, so that the rinsing liquid ismixed with the contents of the pocket and can be sucked out and removedaccording to the overflow principle=creation of head of liquid contact.This process can be made more intensive by adding the intermittentvacuum. If an interruption of the vacuum and ventilation of the suctionfunnel region occurs, possibly due to a rotary valve, then due tocancellation of the vacuum across the interdental cavity, the capillaryforces again become effective and suck the rinsing liquid into theparodontal pockets. If this process is repeated a few times, i.e. thevacuum is utilised by switching-on for certain time intervals, finallysolely rinsing liquid is present, which fills the entire pocket space tothe very bottom, according to a methylene blue test. As an average timerelationship, which can be adapted to the local situation, a time periodof three seconds has proved successful for the alternating phases, apreliminary vacuum of one second occurring first, which is then followedby a rinsing phase of three seconds duration and thus the entire vacuumphase outlasts by one second. Due to the preliminary vacuum, first ofall the crevice is emptied in an optimum manner. Due to the rinsingwhich then occurs, the contents of the pocket located at the upper edgeof the pocket are rinsed away. After two seconds of this jointoperation, the vacuum is again shut off, due to which, as a result ofre-occurrence of the capillary forces, the rinsing liquid is sucked intothe pocket. This operation is limited to one second. Then the vacuum(preliminary) is again initiated and with the beginning of rinsing thesame operation is repeated, a sequence, which is referred to asintermittent vacuum (see FIG. 2, vacuum equals and rinsing equals). Whenadding drugs, the vacuum or respectively the liquid feed is operatedseparately, in order that the drug can drip onto the pocket opening.After shutting off the vacuum, the capillary forces become active forsucking-in the drug. Then, according to a methylene blue test, the drughas penetrated as far as the bottom of the pocket. Since, in the case ofa brief liquid feed, only a few drops of the drug pass into the regionof the pocket opening, this small quantity of liquid remains in theregion of the edge of the gum--the overflow principle of rinsing doesnot come into play here--and when the vacuum is shut off is then suckeddirectly into the subgingival space. Relatively exact dosing is thuspossible.

I claim:
 1. An apparatus for vacuum dental treatment comprising(a) acap-shaped suction member (1) having elastic edges which are adapted tobe applied to the teeth and gum area, the geometry and the material ofsaid suction member (1) being such that said elastic suction memberoverlies the juncture of the gums and teeth to form a closed treatmentchamber, said treatment chamber including the gum pocket defined betweena tooth and the adjacent gum, (b) a feed line (7) for intermittentlysupplying a plurality of increments of treatment liquid into saidtreatment chamber, the outer end of said cap-shaped suction member (1)extending beyond the outlet end of said feed line (7), (c) a vacuumsource connected to said suction member (1), (d) means for adjusting thesuction force exerted on the contents of said gum pocket by adjustingthe vacuum within the suction member (1) to a value which exceeds thecapillary adhesion force that exists in the gum pocket, and (e) controlmeans for the vacuum source and the liquid feed line (7) for setting upa pumping action in the gum pocket which both effects sucking liquid outof the gum pocket and the introduction of treatment liquid to the baseof the gum pocket, said control means being constructed to(a) establisha first treatment phase which causes the suction member (1) to operateunder vacuum alone, (b) establish a sequential second treatment phasewhich causes the suction member (1) to operate under vacuum at the sametime that a treatment liquid is supplied via said feed line (7) and (c)consecutively repeat the above sequence of first and second treatmentphases a plurality of times whereby a repetitive pumping of treatmentliquid both into and out of the gum pocket is achieved.
 2. The apparatusas in claim 1, which includes means for controlling the suction member(1) so that it receives rinsing liquid via the feed line means (7). 3.The apparatus as in claim 1 which includes means for keeping the vacuumconstant during the first and second phases of the treatment cycle. 4.The apparatus as in claim 1, said cap-shaped suction member (1) beingdome-shaped or funnel-shaped.
 5. The apparatus as in claim 1 whereinsaid cap-shaped suction member (1) is formed with a rim portion which isconical.
 6. The apparatus as in claim 1 wherein the said feed line means(7) carries a discharge cannula (2) having a discharge end whichprojects into a space defined by the cap-shaped suction member (1). 7.The apparatus as in claim 6 wherein the discharge cannula (2) isremovably connected to said feed line means (7).
 8. The apparatus as inclaim 1 wherein the said cap-shaped suction member (1) is removablyconnected to a working end of a suction line (3-6, 8) and the other endof said suction line is connected to said vacuum source.
 9. Theapparatus as in claim 8 wherein a section of said suction line (3-6, 8)is formed as a hand piece (5).
 10. The apparatus as in claim 9 whereinthe portion of said suction line means formed as a hand piece (5) isprovided with mounting means (10-12) for receiving an ampoule (13), saidampoule (13) containing a treatment liquid and being connectable to thefeed line means (7) by valve means.
 11. The apparatus as claim 1 whichincludes means to set the vacuum prevailing in the cap-shaped suctionmember (1) to a value between 100 and 150 mm Hg.
 12. The apparatus as inclaim 1 which includes means to place said cap-shaped suction member (1)intermittently under vacuum, the vacuum application interval beingcontinuously adjustable from 1 to 5 seconds.
 13. The apparatus of claim1 wherein said control means in a third phase of the treatment cyclecauses liquid to be supplied via the feed line (7) while the suctionmember (1) is completely shut off from the vacuum source.